Introduction: The Netherlands does not have a national guideline for performing radiographic examinations on pregnant patients. Radiographic examination is a generic term for all examinations performed using ionizing radiation, including but not limited to radiographs, fluoroscopy and computed tomography. A pilot study amongst radiographers (Medical Radiation Technologists (MRTs)) showed that standardized practice of radiographic examinations on pregnant women is not evident between Radiology departments and that there is a need for a national guideline as the varying practice methods may lead to confusion and uncertainty amongst both patients and MRTs. Methods: Focus groups consisting of MRTs from several Radiology departments within the Netherlands were used to map ideas and requirements as to what should be included in the national guideline. Nine focus group sessions were organized with a total of 52 participants. Using a previous review (Wit, Fleur; Vroonland, Colinda; Bijwaard H. Pre-natal X-ray exposure and the risk of developing paediatric cancer; a systematic review of risk factors and a comparison of international guidelines. Health Physics 2021; 121 (3):225e233), the following key points were chosen as discussion topics for the focus group sessions: dose reduction, confirming pregnancy and risk communication. Results: Results showed that the participating MRTs did not agree on the use of lead aprons. That the national guideline should include standardized methods to adjust parameters to decrease radiation dose. Focus group participants find it difficult to ask a patient's pregnancy status, especially when dealing with relatively young and old (er) patients. When communicating the level of risk associated with a radiographic examination the participating MRTs would like to be able to use examples and comparisons, preferably by means of a multilingual website. Conclusion: A national guideline must include information on justification, available alternatives, dose reductions methods and confirmation of pregnancy requirements when fetal dose is a significant risk. Implications for practice: A national guideline ensures standardized practice can be implemented in Radiology departments, increasing clarity of the issues for both patients and MRTs.
Abstract: Since the first Oxford Survey of Childhood Cancer’s results were published, people have become more aware of the risks associated with prenatal exposure from diagnostic x rays. As a result, it has since been the subject of many studies. In this review, the results of recent epidemiological studies are summarized. The current international guidelines for diagnostic x-ray examinations were compared to the review. All epidemiological studies starting from 2007 and all relevant international guidelines were included. Apart from one study that involved rhabdomyosarcoma, no statistically significant associations were found between prenatal exposure to x rays and the development of cancer during 2007–2020. Most of the studies were constrained in their design due to too small a cohort or number of cases, minimal x-ray exposure, and/or data obtained from the exposed mothers instead of medical reports. In one of the studies, computed tomography exposure was also included, and this requires more and longer follow-up in successive studies. Most international guidelines are comparable, provide risk coefficients that are quite conservative, and discourage abdominal examinations of pregnant women.
Rationale: Diagnosis of sarcopenia in older adults is essential for early treatment in clinical practice. Bio-electrical impedance analysis (BIA) may be a valid means to assess appendicular lean mass (ALM) in older adults, but limited evidence is available. Therefore, we aim to evaluate the validity of BIA to assess ALM in older adults.Methods: In 215 community dwelling older adults (age ≥ 55 years), ALM was measured by BIA (Tanita MC-780; 8-points) and compared with dual-energy X-ray absorptiometry (DXA, Hologic Discovery A) as reference. Validity for assessing absolute values of ALM was evaluated by: 1) bias (mean difference), 2) percentage of accurate predictions (within 5% of DXA values), 3) individual error (root mean squared error (RMSE), mean absolute deviation), 4) limits of agreement (Bland-Altman analysis). For diagnosis of low ALM, the lowest quintile of ALM by DXA was used (below 21.4 kg for males and 15.4 for females). Sensitivity and specificity of detecting low ALM by BIA were assessed.Results: Mean age of the subjects was 71.9 ± 6.4, with a BMI of 25.8 ± 4.2 kg/m2, and 70% were females. BIA slightly underestimated ALM compared to DXA with a mean bias of -0.6 ± 0.2 kg. The percentage accurate predictions was 54% with RMSE 1.6 kg and limits of agreements −3.0 to +1.8 kg. Sensitivity was 79%, indicating that 79% of subjects with low ALM according to DXA also had low ALM with the BIA. Specificity was 90%, indicating that 90% of subjects with ‘no low’ ALM according to DXA also had ‘no low’ ALM with the BIA.Conclusions: This comparison showed a poor validity of BIA to assess absolute values of ALM, but a reasonable sensitivity and specificity to diagnose a low level of ALM in community-dwelling older adults in clinical practice.Disclosure of interest: None declared.
Noord-Holland kent een belangrijke en innovatieve maakindustrie. Het gaat hierbij om relatief kleine nichespelers, die een grote internationale markt bedienen. In 2016 werd het TechnoSpitsen netwerk Noord-Holland opgericht, met als doelstelling “Het slim verbinden van (nieuwe) technologieën, kansen en uitdagingen, mensen en kennis, bedrijven en onderwijs, voor een innovatieve en toekomstbestendige maakindustrie”. Door samenwerken in “open innovatie” bundelen bedrijven en Hogeschool de krachten: • Samenwerken met collega-bedrijven, leren van elkaar • Samenwerken met studenten en daardoor een betere instroom van nieuw talent • Samenwerken met docent-onderzoekers, waardoor vernieuwende ideeën kunnen doorstromen naar de praktijk en naar het onderwijs. KIJKEN MET ANDERE OGEN doet praktijkonderzoek naar de mogelijkheden en toegevoegde waarde van moderne beeldbewerkingstechnieken en beeldbewerkingssoftware (computer vision). Door de inzet van geavanceerde vision technieken komen we tot verbeteringen in het ontwerp van hun machine-ontwerp en productieproces. Meer specifiek: • Verbeteringen in productiviteit door kortere cyclustijd of doorlooptijd • Verbeteringen in de productkwaliteit en nauwkeurigheid van werken (zero defects) • Verbeteringen in het storingsgedrag (kortere down-time, minder storingen) • Verbeteringen in de omstelflexibiliteit (sneller overgaan op ander product) Met camera’s die meer kleuren kunnen zien dan het menselijk oog – infrarood, ultraviolet, X-ray kunnen we letterlijk ‘Kijken met Andere Ogen’! Beeldvormende technieken, oorspronkelijk ontwikkeld voor ruimtevaart, astronomie en medische toepassingen, worden als nieuwe beeldvormende chips in compacte behuizingen ondergebracht en komen beschikbaar voor nieuwe robottoepassingen in industrie en agri-food. Met nieuwe GPU gebaseerde HW-architecturen, en moderne deep learning algoritmes, kunnen we relatief snel nieuwe toepassingen met geavanceerde objectherkenning bouwen. Leren uit voorbeelden in plaats van programmeren. Door computer-gegenereerde beelden te combineren met ‘live’ beelden wordt het mogelijk om de resultaten van metingen ‘live’ inzichtelijk te maken (Augmented Reality). ‘Andere ogen’ die meekijken en tips geven tijdens inspectie of training.
Structural Biology plays a crucial role in understanding the Chemistry of Life by providing detailed information about the three-dimensional structures of biological macromolecules such as proteins, DNA, RNA and complexes thereof. This knowledge allows researchers to understand how these molecules function and interact with each other, which forms the basis for a molecular understanding of disease and the development of targeted therapies. For decades, X-ray crystallography has been the dominant technique to determine these 3D structures. Only a decade ago, advances in technology and data processing resulted in a dramatic improvement of the resolution at which structures of biomolecular assemblies can be determined using another technique: cryo-electron microscopy (cryo-EM). This has been referred to as “the resolution revolution”. Since then, an ever increasing group of structural biologists are using cryo-EM. They employ a technique named Single Particle Analysis (SPA), in which thousands of individual macromolecules are imaged. These images are then computationally iteratively aligned and averaged to generate a three-dimensional reconstruction of the macromolecule. SPA works best if a very pure and concentrated macromolecule of interest can be captured in random orientations within a thin layer (10-50nm) of vitreous ice. Maastricht University has been the inventor of the machine that is found in most labs worldwide used for this: the VitroBot. We have been the inventor of succeeding technologies that allow for much better control of this process: the VitroJet. In here, we will develop a novel chemical way to expand our arsenal for preparing SPA samples of defined thickness. We will design, produce and test chemical spacers to allow for a controlled sample thickness. If successful, this will provide an easy, affordable solution for the ~1000 laboratories worldwide using SPA, and help them with their in vitro studies necessary for an improved molecular understanding of the Chemistry of Life.
In dit project wordt de haalbaarheid bestudeerd voor het maken van nanoporeuze membranen met behulp van gangbare processen in de halfgeleiderindustrie. Nanoporeuze membranen bieden onder meer de mogelijkheid om op energie-efficiënte en milieuvriendelijke manier water te ontzouten of het scheiden van vluchtige componenten als alternatief voor destillatie. Recent zijn veel nieuwe nanoporeuze materialen gerapporteerd. Succesvolle toepassingen op het gebied van katalyse, sensoren en scheidingen, waaronder ook eerste voorbeelden van kleinschalige nanofiltratie, geven de potentie van dergelijke materialen aan voor een toepassing op het gebied van nanofiltratie op grotere schaal. Echter, het ontbreekt momenteel aan goede, eenvoudige methoden om deze opschaling voor ultradunne (sub-micron), nanoporeuze membranen te realiseren. In dit project zal wordt een methode bestudeerd en geïmplementeerd waarmee dit wel mogelijk is.
